The specific aim of this Phase I SBIR project is to establish the technical merit and feasibility of producing a modular imagery intervention program for breast cancer patients and survivors that can be delivered to patients in a classroom setting, and/or at-a-distance, via Internet. Phase I prototype will emphasize feasibility of delivery and potential efficacy for improving quality of life and health outcomes. The Phase II project will emphasize overcoming barriers to access of care and accessibility of materials at varying degrees of technical sophistication. Proposed final Phase II products are internet-based multi-media conferencing, DVDs and CDs. Phase I questions: Did breast cancer patients and survivors report satisfaction with the prototype materials and delivery? Did breast cancer participants and breast cancer survivor focus groups report enthusiasm for the Phase II Internet-based multi-media conferencing imagery component? Can the prototype be delivered and tested? Is the prototype safe? Do outcome measures suggest the prototype will improve patient quality of life? In Phase I, applicant will (1) produce paper and/or sample materials for the imagery prototype (i.e., patient manuals, audio cassettes, behavioral change assessment instruments); (2) evaluate materials for accuracy and patient satisfaction before delivery (initial review) and after feasibility trial (final review) by providing focus group summary reports and Likert scale data and updating the prototype to reflect recommendations; (3) test feasibility of program delivery in two sub-sets of post-surgical breast cancer patients (i.e., treatment with no IV-chemotherapy [N=15] and treatment with IV chemotherapy [N=15]); (4) test short-term effects of the imagery program (i.e., physical, mental, emotional, social, functional and spiritual well-being and salivary cortisol rhythm). If Phase I is successful, the Phase II focus will be to finalize and test the prototype with 120 breast cancer patients. All related products will be provided on DVD-ROMs, CD-ROMs, and as an interactive website providing at-a-distance instruction. Train-the-trainer materials, with certification procedures and competency evaluations, will also be developed in Phase II. Currently, no imagery program exists that has been specifically tested for efficacy to improve quality of life in breast cancer populations; maintains quality control standards for certification, delivery and training; addresses barriers to access of care; and is available to the mainstream public health community. The development and marketing of this prototype will support the NCI goal of improving cancer patient quality of life. Imagery research to date suggests that a well-crafted imagery protocol could improve quality of life and health outcomes for breast cancer patients.